Stapled renal vein with in situ tumor thrombus: a useful intraoperative maneuver to facilitate radical nephrectomy and inferior vena cava thrombectomy.

Objectives: Patients with genitourinary tumors and inferior vena cava thrombus often have large lesions and significant neovascularity. Early division of the renal vein with the in situ thrombus is desirable; however, concerns have been raised regarding tumor spillage and thrombus migration. We describe a novel technique using a stapling device to secure the renal vein during resection of renal tumors associated with an inferior vena cava thrombus.

Topiramate-induced psychosis in patients with essential tremor: report of 2 cases.

Two patients with essential tremor who had no psychiatric history developed symptoms of psychosis (visual hallucinations, paranoia, and vivid dreams) 3 days after starting topiramate (25 mg BID) for tremor control. All adverse symptoms resolved several days after topiramate was discontinued.